RATIONALE: Lymphadenectomy may remove tumor cells that have spread to nearby lymph nodes in patients with invasive bladder cancer. It is not yet known whether extended pelvic lymphadenectomy is more effective than standard pelvic lymphadenectomy during surgery.

PURPOSE: This randomized phase II trial is studying standard pelvic lymphadenectomy to see how well it works compared to extended pelvic lymphadenectomy in treating patients undergoing surgery for invasive bladder cancer.

To collect peripheral blood and two paraffin-embedded blocks of the primary tumor for translational medicine studies, including circulating tumor cells (CTCs) and markers of epithelial and mesenchymal transition, and correlate these findings with pathologic T stage and node metastasis as well as DFS and OS.

Predominant urothelial carcinoma with any of the following elements allowed:

Adenocarcinoma

Squamous cell carcinoma

Micropapillary or minor components of other rare phenotype

No pure squamous cell carcinoma or adenocarcinoma

No visceral or nodal metastatic disease proximal to the common iliac bifurcation by 2-view chest x-ray and abdominal-pelvic imaging by computerized tomography or MRI of the abdomen and pelvis

No intra-operative pelvic lymph node involvement (confirmed by frozen section) at or above the bifurcation of the common iliac vessels in any of the extended template

PATIENT CHARACTERISTICS:

Zubrod performance status 0-2

ALT and AST ≤ upper limit of normal (ULN)*

Alkaline phosphatase ≤ ULN*

Not pregnant or nursing

Fertile patients must use an effective contraception

No other prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or stage I or II cancer from which the patient is in complete remission for the past 5 years

Prior neoadjuvant chemotherapy for this cancer allowed provided it has been completed and patient has recovered

No prior pelvic irradiation

Contacts and Locations

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Please refer to this study by its ClinicalTrials.gov identifier: NCT01224665